To Die For

In commenting on the case of Sean Davison – the man who has just been convicted of assisting the suicide of his terminally-ill mother – John Kleinsman (the director of the Nathaniel Centre, the New Zealand Catholic Bioethics Centre) makes the salient point that legalising euthanasia will leave the elderly vulnerable to pressure from family, health professionals and society in general to “end it all”. As he says

The “right to die” will quickly become a “duty” to die.

The MacDoctor has made this same point on a number of occasions. The fear of becoming a “burden” is a very powerful one in the elderly and it could easily be manipulated into an assumption that death is an obligation – that if you are not willing to die, you must be “greedy” and “selfish”. In case you think I am exaggerating here, I have heard these exact phrases from the mouths of the families of frail elderly people.

What Mr. Kleinsman may not appreciate is the awful pervasiveness of the expectation of euthanasia that quickly permeates the medical profession and, indeed, society as a whole. Instead of attempting to alleviate pain and ameliorate incurable disease – restoring a level of dignity to the frail elderly, doctors quickly develop the assumption “you don’t want us to resuscitate you, do you?”. This swiftly mutates to “you just want us to make you comfortable, don’t you?” which actually means “you want your end to bring as little distress to your family as possible”.

Treatment becomes with-held because it is “pointless” – which does not mean “futile” but “prolongs life unnecessarily”. Sedation becomes more important than adequate pain relief. Food and water become an optional extra. Investigations as to the cause of the deterioration in the elderly patient are quietly shelved in the name of the same “pointless” mantra. “Patient care” takes on a very different and deadly meaning.

These attitudes are already present in your hospitals. Legalising euthanasia will just allow them to flourish and become the norm. It will not matter if you are a normally fit and healthy 80-year-old. If you develop a pneumonia and become a little do-lally, you will not be rescued. You will die. This is not dramatic hyperbole.

The reason this will happen is simply because there will be no incentive for any other result. After all, families will get rid of their troublesome elders in a manner that will assuage their consciences. Even the most loved grandmother can be an unmitigated nuisance, so the incentive will be there – in the background – in even the most caring family circle. Doctors will be happy because it is far simpler to allow an elderly person to die, than it is to investigate and treat them. And restoring the elderly to partial health can be very unrewarding and the parties involved are rarely completely happy with the state of affairs.

Hospitals will like the drop off in expensive investigations and treatments and will be able to move their budgets towards the more “deserving”, younger people.

Governments score double with reduced health AND reduced pension requirements. What’s not to like? That nice Mr. Key may never have to break his promise and raise the retirement age.

Even old folk will join in with peer pressure as society begins to look on old age as a liability rather than an asset. The frailest will go first, of course, but eventually anyone over a certain age will be a target. Those who think that euthanasia will be limited to those who are “terminal” have little concept how easily that word can come simply to mean “old”.

One day we will all be elderly. One day we will all be infirm. If we allow euthanasia to be legalised, no matter how circumscribed, we will find ourselves at the mercy of the merciless – pressurised into ending our lives prematurely. We should not allow our natural sympathies for the plight of someone like Sean Davison to lead us into a place where the elderly are abandoned by the very people who should care for them.

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